Medicaid

Program Goal

To increase access to health care coverage for low income individuals, families and children.

Eligibility

Medicaid is a program for low-income persons whose income and/or resources are below certain levels. Eligible populations include children, pregnant women, single individuals, families and individuals certified blind or certified disabled. In addition, persons with medical bills may be eligible for Medicaid even if their income and resources are above the allowable Medicaid income levels. Medicaid income and resource levels generally change on January 1 of each year. Only certified blind individuals, certified disabled individuals, and individuals over 65 have a resource test. Children and families may be eligible for Child Health Plus or Family Health Plus if they are not eligible for Medicaid.

Description

Medicaid offers a full range of health services for eligible persons including:

  • All regular medical checkups and needed follow-up care.
  • Immunizations.
  • Doctor and clinic visits.
  • Medicine.
  • Medical supplies.
  • Medical equipment and appliances (wheelchairs, etc.).
  • Lab tests and x-rays.
  • Eye care and eye glasses.
  • Emergency care.
  • Dental care.
  • Nursing home care.
  • Emergency ambulance transportation to a hospital.
  • Hospital stays.

For some pregnant women, services may be limited to perinatal care if their incomes are too high to qualify for full Medicaid coverage.

For children birth to 21 years old, Medicaid offers the Child/Teen Health Program (C/THP), which provides the services listed above for all Medicaid recipients. C/THP places an emphasis on preventive care and treatment. For example, Medicaid requires that all children be screened with a blood lead test at one and two years of age. C/THP is available from fee-for-service healthcare providers. Also, all managed care plans must offer C/THP to Medicaid recipients under 21 years of age who are enrolled in their plan.

Child Health Plus and Family Health Plus provide services to eligible children and adults, respectively, through managed care plans.

For More Information

Call the New York State Health Department's Growing Up Healthy Hotline at 1-800-522-5006, or contact your local county Department of Social Services. In New York City, call the Information Hotline at 311 or (718) 557-1399.

For more information about Medicaid, visit the Medicaid website: www.health.ny.gov/health_care/medicaid/.

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Publication 0548
Revised 10/2013